Four- to seven-year follow-up of pharmacological postconditioning with mangafodipir as an adjunct to primary PCI in ST-segment elevation myocardial infarction

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging Pub Date : 2023-06-10 DOI:10.1111/cpf.12839

Walid El-Saadi, Jan Engvall, Jan-Erik Karlsson, Eva Maret

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引用次数: 0

Abstract

Introduction

Adverse left ventricular remodelling (AR) develops over time in approximately 30% of patients with a history of coronary artery disease. AR manifests as a structural change in the left ventricle (LV) in terms of increased volumes and reduced left ventricular ejection fraction (LVEF). Manganese dipyridoxyl diphosphate (mangafodipir) has demonstrated interesting cardioprotective features in acute myocardial ischaemia. Pharmacological postconditioning (PP) with mangafodipir as an adjunct to primary percutaneous coronary intervention may possibly reduce the development of AR over time in ST-elevation myocardial infarction (STEMI). The aim of this 4–7-year follow-up study is to investigate the potential benefits of PP with mangafodipir in STEMI patients.

Method

Thirteen out of the initial 20 patients that were included in the primary study of Karlsson et al. were followed up between April and June 2017. The study group underwent review of the hospital records, a clinical examination with ECG and blood sample analysis before cardiac magnetic resonance examination of the patient. LVEF, left ventricular diastolic volume, left ventricular end systolic volume, LV mass and myocardial strain in all directions were computed.

Results

The PP group showed a decrease in LV volume, mass and higher LVEF at follow-up (p < 0.05) while the individual response of the placebo group showed features that are seen in AR. Although there was no difference in myocardial strain, measurement for the PP-group was higher in absolute terms.

Conclusion

Pharmacological postconditioning with mangafodipir in STEMI demonstrated cardioprotective features compared to the placebo group at follow-up. This article is protected by copyright. All rights reserved.

Abstract Image

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在st段抬高型心肌梗死患者中，使用曼加地吡作为辅助手段进行首次PCI的药物后处理的4 - 7年随访

不良左心室重构(AR)随着时间的推移在大约30%有冠状动脉疾病史的患者中发展。AR表现为左心室(LV)的结构改变，表现为左心室容量增加和左心室射血分数(LVEF)降低。二磷酸二吡哆氧基锰(mangafodipir)在急性心肌缺血中显示出有趣的心脏保护作用。经皮冠状动脉介入治疗的药物后处理(PP)加曼加地吡可能会随着时间的推移减少st段抬高型心肌梗死(STEMI)患者AR的发生。这项为期4 - 7年的随访研究的目的是调查PP联合曼加地吡对STEMI患者的潜在益处。方法Karlsson等人在2017年4月至6月期间对最初纳入研究的20例患者中的13例进行随访。研究小组在对患者进行心脏磁共振检查之前，对医院记录进行了回顾，并进行了心电图和血液样本分析的临床检查。计算LVEF、左室舒张容积、左室收缩末容积、左室质量、各方向心肌应变。结果PP组随访时左室体积、质量下降，LVEF升高(p < 0.05)，而安慰剂组的个体反应表现出AR的特征。虽然在心肌应变上没有差异，但PP组的测量值绝对值更高。结论在随访中，与安慰剂组相比，曼加地吡在STEMI中的药理后处理具有心脏保护作用。这篇文章受版权保护。版权所有。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Physiology and Functional Imaging 医学-生理学

CiteScore

3.40

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest. Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.